May is Mental Health Awareness Month, and World Maternal Mental Health Day is observed on May 3rd. This month on The Sanctuary Blog, Karen Markiewicz shares her research on perimenopause as it relates to reproductive mental health and wellbeing.
I often describe my life as a tapestry woven with faith, family, and service. Like countless other Christian women, I have journeyed through seasons of joy and sorrow, growth and change, constantly evolving in my relationship with God and myself. Yet, one pivotal transition has been shrouded in silence and shame: menopause.
The term perimenopause (which translates to “around menopause”) describes the phase of life that marks the end of the reproductive years and the natural transition of women’s bodies to menopause. The menopausal transition is another name for perimenopause. Perimenopause begins at varying ages, but generally women may see changes in their early forties and onwards. This phase is marked by hormonal fluctuations and physical shifts; however these hormonal changes can also significantly impact our mental health and spiritual wellbeing.
Women’s experiences of menopause are deeply unique; some women have an easy transition, while others, like me, experience challenges. I entered menopause with limited knowledge and even less preparation. At fifty-three, I confidently assumed I could breeze through menopause as 20% of women in Western cultures do.
My physical health was good, my faith strong, and life felt stable. Yet, within months, hot flashes ambushed me, sleep vanished, and anxiety morphed into panic attacks. My “brain fog” made even simple conversations exhausting. Worse, my spiritual life was engulfed in a fog of its own. I could barely go out of the house and my self-esteem plummeted. The woman I knew seemed lost, and I felt abandoned by God to navigate this emotional rollercoaster alone.
Seeking support within the Church revealed a disheartening silence. The older women I approached for help brushed my concerns aside, urging me to “pray through it.” This dismissive response compounded my shame, making me hesitate to reach out for the pastoral support I desperately needed, as I attempted to make sense of my experiences.
These encounters mirrored the broader silence in the Western church regarding menopause. To the extent that Western culture has created space for a woman’s midlife experience, that space has been defined by an overemphasis of the medical components of menopause, while neglecting the potential profound psychological and spiritual dimensions of the experience.
My menopausal transition coincided with studying for a master’s degree in Spiritual Formation. When I came to write my thesis, I decided to research the spiritual impact menopause can have on Christian women’s faith journeys, which turned out to be an extremely under-researched subject. One woman I interviewed for my research, ‘Deanna,’ mentioned the following. “My hormones felt like I was swinging on a pendulum. It was a chaotic season in my life where I began to feel suicidal and nearly left my husband. I knew God loved me, but my symptoms left me overwhelmed and unable to cope.” Women like Deanna are more numerous than we think. Even though she knew God loved her deeply, Deanna felt unable to raise these issues in her church. However, she did speak with health professionals and did receive the medical help needed. She was also accompanied by close female Christian friends who supported her spiritual journey. Deanna is now thriving and says her faith is more real to her, but that season was a dark experience she never expected.
Current statistics speak volumes regarding this season of a woman’s life. According to the UK’s Office for National Statistics1 and the Centers for Disease Control and Prevention in the US,2 women aged forty-five to fifty-nine (UK) and forty-five to sixty-four (US) had the highest age-specific suicide rate, which correlates to the average perimenopausal age. Also in other research,3 75% of women stated they had never had mental health concerns before going through perimenopause, and of the 2,000 perimenopausal women in the UK who took part in the research, just over 25% had not sought medical assistance for mental health symptoms. In a Canadian study, 72% of survey respondents reported the medical advice they sought for menopause to be unhelpful. Four out of ten women survey respondents in Canada also reported feeling alone throughout the process of menopause.4 This raises the question: how many women are suffering in silence?
Breaking this silence requires a two-pronged approach. First, churches must actively become sanctuaries for open conversation about perimenopause and menopause. We need pastors equipped to offer compassionate support, understanding the intricate relationship between hormones, faith, and mental health. Let our pulpits resonate with women’s lived experiences, replacing shame with understanding, and becoming a safe place to share physical, psychological, and spiritual realities.
Second, individual women must embrace courage and vulnerability. Let’s share our stories, not in whispers but with open hearts and voices. Remember, we are created in God’s image, and menopause is merely another chapter in our unique unfolding. Just as Deanna found support and healing through medical intervention and trusted friends, so can we.
My own journey, while initially shrouded in darkness, ultimately became a spiritual pilgrimage, a journey to a sacred place. With medical help, including Hormone Replacement Therapy, and a renewed focus on self-care and spiritual care, I emerged stronger and more deeply connected to my faith. For me, menopause wasn’t a curse, but a crucible. I found it an opportunity to forge resilience, deepen my faith, and emerge with a renewed sense of self. The combination of my own lived experience and my master’s research has led me to a new project. I am currently writing a book, entitled Menopause Pilgrims. It includes many different women’s stories of their lived experience, but focuses on how we can travel this journey of menopause openly and positively, celebrating one another with pastoral guidance.
I want to pave the way for future generations of Christian women to embrace menopause with grace, hope, and resilient spirits. Menopause is a crucial time for biopsychosocial development, but it also highlights the ways in which a spiritual faith may provide perspective, resiliency, and hope in the face of difficulties. Menopause can present an opportunity to reevaluate our spiritual life.
To learn more about Karen’s research or participate in her book project, please email her at karen@menopausepilgrims.com.
[1] Mais, David, Emyr John, and Rabiya Nasir. 2021. Review of Suicides in England and Wales: 2021 Registrations. Office for National Statistics. 2021. ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/suicidesintheunitedkingdom/2021 registrations#suicide-patterns-by-age
[2] Garnett, Matthew, Sally Curtin, and Deborah Stone. 2022. Review of Suicide Mortality in the United States, 2000–2020. Centers for Disease Control and Prevention. March 2022. Suicide Mortality in the United States, 2000–2020. https://www.cdc.gov/nchs/products/databriefs/db433.htm#:~:text=The%2.
[3] Ross, Lynsey. 2022. Review of Menopause: A Divorce “Danger Zone”. Stowe Family Law. August 17, 2022. https://www.stowefamilylaw.co.uk/blog/2022/10/17/menopause-a-divorce-danger-zone/.
[4] Ko, Janet, and Trish Barbato. 2022. Review of The Silence and the Stigma: Menopause in Canada. Menopause Foundation of Canada. 2022.
Cover photo by Rosalind Chang on Unsplash
KAREN MARKIEWICZ
Karen is a Chaplain, Coach and Associate Minister in England. Karen brings fifteen years of missionary experience and a Masters’ Degree in Spiritual Formation to her work in chaplaincy. Karen is due to publish her first book that explores spiritual formation and the menopause. Her passion for spiritual formation drives her upcoming online initiative, Menopause Pilgrims. This offers practical pastoral support and community to Christian women navigating their menopausal journey through a spiritual lens.
karen@menopausepilgrims.com | +44 7554 427544